Denied And Misdiagnosed

[Bystander]

Hi,

I am in the process of starting an appeal. I have been denied an increase for ptsd and depression, and denied SC for my Neck and Back. I am currently at 30% for ptsd w/ Depression, unemployed, and on SSD. What is the best way to go from here?

Should I file a NOD, or just a Formal Appeal? I submitted new information, including a personal statement, the last time I filed, but was still denied. I have documentation from the medical center from while I was enlisted for my neck and back, but it was not a chronic issue back then, but with the lack of proper care/treatment from the va, it has gotten to the point where I can no longer function. I have been diagnosed with Bulged Discs, Calcification of Ligaments, Loss of Curve. Have frequent Headaches. The Pain Medications I have been prescribed from the va don't help. I was misdiagnosed with Personality Disorder when discharged from the Army, and later diagnosed with PSTD and Depression. I filed a request for earlier effective date, due to the misdiagnosis, and that was also denied.

I have documentation from my Psychiatrist stating that I have been under her treatment since "2012 until present for PTSD, Prolonged. Characterized by Chronic Anxiety, Depressed Mood, Social Isolation, Insomnia, nightmares, flashbacks, hyper vigilance, startle response, avoidant behavior, and inability to deal with day to day stressors". She also states that my "chronic mental illness clearly interferes with my day to day functioning and ability to function in a work environment with other people."

She adds that she does not see any symptoms of me having a Personality Disorder.

This Is My Problem! They Double Talk Themselves.

When I filed for an increase for PTSD, they denied it stating, "The examiner opined that my history of mood changes, sometimes several times a day, and pattern of conflicted relationships, is more consistent with a diagnosis of personality disorder than PTSD. The examiner again noted that my personality disorder was mostly the source of my occupational and social impairments, and that my clinical presentation is more consistent with a personality disorder than ptsd.!

THEN,

When I filed SC for Aggravated/Exacerbated Personality Disorder by my ptsd and military service, it was denied stating that my doctor did not see symptoms of Personality Disorder.!

So, in one paragraph, I have a Personality Disorder, and not PTSD... and in the very Next paragraph, I have PTSD, and Not a Personality Disorder...?

Please Help...

[Bystander]

Thanks for the info!

I've been waiting to see a private doctor, but I don't have the money at the moment. I've been waiting for quite some time, and my financial situation is becoming more and more unstable. I will try to see if they have mental health services at the health department today. And I'll get a report from SSD, but I didn't have to see their doc, so I'm not sure how much info would be in their file.

If I file a FDC, can I submit new evidence? Or, if I finally get to see a private doc, are my only options to file a NOD, or Formal Appeal...

Thanks again!

[TiredCoastie]

You have the right to submit new evidence even without a claim or an appeal so long as it's been less than a year from your claim decision date. Seeing a private doc does not limit your options. It only strengthens whatever option you choose. As you can tell, there are a lot of different ways to go about this.

In terms of the PD vs PTSD, the suggestion to get an outside opinion is a very good one. Is the VA treating you for PTSD? One of your earlier posts seemed to indicate that. But if the VA is not believing its own doctors, getting one from the outside to evaluate and wrap this up for you in a neat package having reviewed your SMRs and treatment records post-service may be the ticket to getting this problem straightened out. We can only go on the diagnoses given by the treating physicians or find a different doctor to make a different diagnosis. If that diagnosis changes because it was found to be wrong, then that's completely understandable. However, for the VA to compensate for PTSD, the VA has to be actively treating you for PTSD.

What did you file with the SSA to get SSD? That's got to also be a powerful piece of evidence in your favor if they agree it's PTSD and NOT a PD.

What avenue to take to straighten this out? I still say NOD/appeal to protect your original claim date if it's still within a year of the claim denial. It will take longer than an FDC. But it will protect your original claim date which means more retro. If it's been beyond a year, then your options are more limited to either a claim like an FDC or potentially a CUE. Here's why, IMHO, the appeal process is the best way:

* You get more retro if you win by standing on the original claim date and making the VA fix a wrong decision rather than give you a new one to cover up the old.

* You have a better overall probably of success if you had a solid claim in the first place. The higher in the "food chain" you go, the better case review you'll get. Others have stated pretty bluntly on this forum that the BVA can read and that can be the difference between straightening this out and not.

* Even if you submit new evidence with a claim, like an FDC, and you gain a higher rating or service connection, there's no telling what could be wrong with that new decision. Then you'll have to appeal anyway to make it right.

Another option that I don't know much about is just submitting the new and material evidence on the old claim so long as that claim decision is less than a year old. I don't know how the VARO treats that action - as a new claim or as some sort of reopening of the decided claim? Someone else will have to chime in. There have been some posters who have simply submitted new evidence on top of new evidence to force a review of the claim decision time and again. My concern is that if the same people are not making a different decision, then there's that old adage about doing the same thing over and over and expecting something different to happen... So, in my mind, ultimately you'll wind up appealing anyway maybe years down the road.

My brother, Navy04, has a different opinion on this as do most VSOs. If your focus is the higher monthly compensation check sooner rather than the lump sum later, and you're fairly confident that a second look within the VARO will result in service connection and a higher rating, then submitting new evidence without an appeal, either under a new claim or not, is a good decision for you. However, you're wrestling with service connection of a disorder that could result in you losing your life. If it were me, I'd fight the strongest with the highest probability of gaining service connection not just because of the compensation now but also to enable your spouse to obtain DIC later...for me, that's through the appeal process.

I went down the "claim" road myself and wound up appealing both the original denial and the subsequent claim's decision...and am waiting to see both appeals combined now both to gain SC of a difficult condition and to protect the original claim date. I am also trying to obtain SC of a potentially life threatening condition. If it were to end my life, I know my wife would have little idea how to proceed to obtain DIC if I didn't already establish SC. So getting it "fixed right" is more important to me rather than getting it "better faster."

[GatorNavy]

A claim is a claim. As in the Highlander: "there can be only one"

FDC, BDC, BFF or FNG claim.It really doesn't matter. It's just another hamster on the wheel. As long as the RO doesn't raise the bar on the amount of approved claims or all of a sudden pull off a higher accuracy rate, then we will continue to be stuck in the tar pits of appeals for years. I'm sure the RO would be glad to open another claim on the previously denied contentions. That way they can say that the condition didn't exist until now. They will gladly deep-six all of your evidence and remove your prior effective date as well.

We add contentions or conditions to that claim and we ask for increases on those contentions found to be service connected. We work our claims to the bitter end. For those of us with serious chronic conditions well, we will most likely battle the VA for the rest of our lives. We can add evidence any time along the way, up until the BVA hearing and for 60 days after the hearing under certain circumstances. You can ask for a review or a hearing on supplied evidence on a previously denied claim at any time. If the NOD is not timely however, then check-mate, game over you lose. Everything I have stated here is on this site somewhere for reference. Asknod, Berta, Carlie just to name a few. Now back to ranching. The ducklings need a new home as they have turned the chicken house into a swimming pool.